*Employees/owners who perform private investigation services. Do not include clerical or sales payroll.

Services provided: Please check services that you now provide or would provide if requested.

Narcotics Surveillance

Auto Repossession

Bodyguard/Exec. Protection

Store Detective (Arrests)

Polygraph/PSE Exams

Foreclosure Sales

Bank Account Searches

Asset Searches

Online Searches

Accident Reconstruction

Arson Investigations (C&O)

Attorney/Legal Investigations

Insurance Fraud Investigations

Locate People/Witnesses

Domestic Surveillance

Undercover Operatives

Guard Service/Property Protection

Process Service

Subpoena Service

Pre-employment Backgrounds

Electronic Countermeasures

Other

Do you or any of your employees carry a firearm?

Yes

No

If YES, are they licensed?

Yes

No

NOTICE TO APPLICANTS:This application must be completed in full as the quote will be based soley on the information provided. Any person who knowingly and with intent to defraud any insurance company or other person, files an application for insurance containing false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act. Which is a crime by initialing this application. The signor warrants that to their best knowledge all information given is true and accurate.